The purpose of this research is to clarify the barriers to pain management for cancer patients in the terminal stage. Once the barriers have been identified we consider effective measures to reduce these barriers.In 1997, we developed a questionnaire based on a references review and a pretest. A survey was conducted with a sample of Osaka University Hospital nurses. We compared the results of this stage with those of the Slone-Kettering Cancer Center in New York, USA. The findings showed the knowledge-base of pain management in our nurses was lower than their counterparts at the Slone-Kettering Cancer Center : specifically insufficient knowledge and unsuitable assessment. Cross-cultural differences were identified in regards to barrier recognition during the stage of this research.In 1998, nursing records at Osaka University Hospital were analyzed to identify areas of distress in cancer patients in the terminal stage. Cancer patients mainly exhibited physical distress with notable diff
… Moreerences between the beginning and end of the terminal stage. In addition, both doctors and nurses were surveyed about barriers to pain management. We found that doctors had a low rate of barrier identification while both doctors and nurses rated low in identifying "unsuetable assessment" as a barrier to pain management in cancer patients in the terminal stage.In 1999, we conducted a survey of the families of cancer patients to determine their expectation of the medical staff. The results showed that families want doctors to administer patient-centered care rather than medical-based research and physical examinations. Families also identified their desire for easily understandable informed-concent, as well as psychological support for cancer patients in the terminal stage. However, the survey showed that families want nurses to be gentle and cheerful with patients while expressing humanistic qualities.It is necessary to present these results to medical staff and address these issues brought by these results. We need to open the discussion in order to change the system of pain management in hospitals through the continuing education of medical staff. Then the results must be used in the training of nursing students so they will be better aware of efficient pain management of cancer patients in the terminal stage. Less